Evaluation of Differences in Patellar Height After Patellar Stabilization Procedures Not Intended to Address Patella Alta: A Multicenter Study.

Autor:	Kreulen RT; Department of Orthopaedic Surgery, Johns Hopkins, School of Medicine, Baltimore, Maryland, USA., Anderson G; Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA., Yalcin S; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA., Hart JM; Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, North Carolina, USA., Shank K; Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA., Fury MS; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Elias JJ; Department of Health Sciences, Cleveland Clinic Akron General, Akron, Ohio, USA., Tanaka MJ; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Farrow LD; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA., Diduch DR; Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA., Cosgarea AJ; Department of Orthopaedic Surgery, Johns Hopkins, School of Medicine, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2024 Mar 20; Vol. 12 (3), pp. 23259671241235597. Date of Electronic Publication: 2024 Mar 20 (Print Publication: 2024).
DOI:	10.1177/23259671241235597
Abstrakt:	Background: Recent studies have reported conflicting results as to whether isolated medial patellofemoral ligament reconstruction (MPFLr) leads to decreased patellar height. Purpose: To investigate if patellar stabilization surgery not intended to address patella alta influences patellar height. Study Design: Cohort study; Level of evidence, 3. Methods: A multicenter retrospective chart review was conducted, and patients who underwent MPFLr, medializing tibial tuberosity osteotomy (TTO), and/or trochleoplasty between 2016 and 2020 were included. The Caton-Deschamps index (CDI) was calculated from radiographs obtained preoperatively, 2 weeks postoperatively, and 3 months postoperatively. The preoperative CDI value was compared with the 2-week postoperative and 3-month postoperative values according to stabilization procedure (isolated MPFLr, isolated TTO, MPFLr + TTO, MPFLr + trochleoplasty, and MPFLr + trochleoplasty + TTO) using the paired t test. Analyses of the 1-bundle versus 2-bundle MPFLr technique and the presence of lateral retinacular release or lateral retinacular lengthening were conducted on the isolated MPFLr and combined MPFLr + TTO cohorts. Results: A total of 356 knees were included. Statistically significant pre- to postoperative decreases in CDI were seen in all stabilization procedures analyzed ( P ≤ .017 for all). Within the isolated MPFLr cohort, this significant decrease was seen at 2 weeks postoperatively with the 2-bundle technique (ΔCDI = -0.09; P < .001) but not with the 1-bundle technique (ΔCDI = -0.01; P = .621). Conclusion: The different surgical techniques analyzed in the current study affected patellar height, even when a distalizing TTO was not performed. The decrease was dependent on surgical technique, with a 2-bundle MPFLr leading to a statistically significant decrease and a 1-bundle MPFLr effecting no change. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: G.A. has received education payments from Arthrex and Medical Device Business Services and hospitality payments from Exactech. M.S.F. has received education payments from Kairos Surgical. M.J.T. has received education payments from Kairos Surgical and Supreme Orthopedic Systems. L.D.F. has received hospitality payments from DJO. D.R.D. has received consulting fees from DePuy Synthes, Medical Device Business Services, and OsteoCentric Technologies and royalties from OsteoCentric Technologies and Smith & Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Cleveland Clinic (ref No. 21-623), Johns Hopkins Medicine (ref No. IRB00266398), University of Virginia (ref No. 22690), and Massachusetts General Hospital. (© The Author(s) 2024.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu